Patient satisfaction at Hudson Valley hospitals is below nationwide levels -- though in line with New York State peers -- according to a widely used standardized survey.

At the 22 Hudson Valley hospitals participating, an average of 64 percent of patients said they would recommend the institution to friends and family, identical to the rate for hospitals throughout the state but below the 70 percent recorded nationwide, according to the HCAHPS survey -- for Hospital Consumer Assessment of Healthcare Providers and Systems.

Similarly, 8 percent of Hudson Valley patients said they would probably not or definitely not recommend their hospital -- on average -- compared with 7 percent around the state and 5 percent nationwide.

The results of the survey and complementary rankings based on statistics like fatal complications after surgery are of more than academic interest to Hudson Valley hospitals. The federal government has begun withholding 1 percent of the pot for Medicare reimbursement and doling that money out based on hospitals' performance and improvement over time, as measured by the statistics.

James Knickman, chief executive of the New York State Health Foundation, a not-for-profit advocacy group, said the results-oriented program represents a shift away from paying hospitals based solely on the procedures they perform on a patient.

"This is the whole notion of paying for value and paying for outcomes rather than paying for just doing things," he said. "This is where we're going in health care."

The hospital with the lowest percentage of patients who definitely would recommend it to family and friends (51 percent) and the highest percentage of those who would "probably or definitely not" recommend it (14 percent) was Kingston Hospital. Kingston Hospital officials did not immediately respond to a request for comment.

Deborah Neuendorf, vice president of administration at Hudson Valley Hospital Center, joined Kathy Webster, vice president of patient services at Hudson Valley, to comment on the results of the survey.

Neuendorf said hospital administrators are attentive to feedback.

"It's our whole culture here to be patient-centered," she said.

Webster suggested that high ratings with patients are closely related with good communications work by the nurses who are the patient's key contacts.

In a survey released in December by the federal Centers for Medicare & Medicaid Services -- also a factor in Medicare reimbursements -- a different set of Hudson Valley hospitals was ranked based on patient safety overall and specifics like fatal complications after surgery and accidental puncture or cut.

In almost all of those measures, the Hudson Valley hospitals were in line with the nationwide rate, but St. Luke's Cornwall Hospital in Newburgh, Good Samaritan Hospital in Suffern and St. John's Riverside Hospital-ParkCare Pavilion in Yonkers posted patient safety ratings better than the U.S. rate.

Janine Logan, director of communications for the Northern Metropolitan Hospital Association, which represents Hudson Valley hospitals, said the government's initiative to link 1 percent of Medicare reimbursement to quality care under the Affordable Care Act is historic.

"Medicare reimbursements will be reduced by $850 million [1 percent]; hospitals will have the opportunity to 'earn back' that money by exceeding national benchmarks or achieving performance improvements," she said in an email.